Presumed Choline Chloride Toxicosis in Cats With Positive Ethylene Glycol Tests After Consuming a Recalled Cat Food.

Four previously healthy adult domestic shorthair cats (2 male, 2 female) from one household developed acute vomiting and ataxia less than 12 hours after consuming a commercial canned cat food. Blood work abnormalities included mild hyperglycemia with increased alanine aminotransferase (n = 1) and decreased blood urea nitrogen (n = 2). The veterinarian conducted whole blood ethylene glycol (EG) tests, which were positive for all cats. There were no known EG exposures. All cats were treated for suspected EG toxicosis and fully recovered after 48 hours. Separately from the cats' case, the same food was voluntarily recalled by the manufacturer 5 days later due to a higher-than-formulated amount of choline chloride added to the food. The 4 cats' canned cat food was tested for choline, choline chloride, EG, diethylene glycol, and propylene glycol to look for causes of the positive whole blood EG test. The cat food contained an average of 165,300 ppm (165,300 mg/kg) choline and 221,600 ppm (221,600 mg/kg) choline chloride on a dry matter basis, which is at least 65 times the recommended choline amount for adult cats. No glycols were detected. This case documents suspected choline toxicosis in cats after consuming a commercial canned cat food with a higher-than-formulated amount of choline chloride, and it suggests that choline toxicosis may cause a positive result on some EG whole blood tests. Choline toxicosis could be a possible differential diagnosis when a cat has a positive EG test and no known exposure to antifreeze.